Morbidity and mortality

r 9


Morbidity and Mortality



U. S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

PUBLIC HEALTH SERVICE


COMMUClABL E DISEAECNTR


634-5131


ATLANTA, GEORGIA


PROVISIONAL INFORMATION ON SELECTED NOTIFIA
DEATHS IN SELECTED CITIES FOR W'EFt


BRUCELI

A total of 12 cases of brucellosis was reported for the
weekended July 11. This brings to 213 the cumulative total
of cases reported thus far in 1964. For the comparable
period of 1963,189 cases were reported. A table of reported
brucellosis cases through the 28th week and the annual
totals for the past 5 years is shown in the accompanying
table.
Of the cases reported to date in 1964, the 7 States
comprising the West North Central area have reported 99
(47 percent) of the U. S. total. Iowa accounts for 58 of the
4
99 cases. Cases have been reported from each geographic
subdivision, and from 32 States and New York City this
year.


1964 1963 1962 1961
212 189 222 321


1960
460


Annual Totals
382* 409 636 751

* Provisional total


Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
Week Ended Cumulative. First Weeks
Disease Median Median
1964 1963 1959 1963 1964 1963 1959 1963
Aseptic meningitis ................ 34 49 --- 829 708 ---
Brucellosis ....................... 12 15 15 212 189 321
Diphtheria ........................ 6 2 4 144 143 318
Encephalitis, primary infectious.. 32 3 --- 1,005 ---
Encephalitis, post-infectious ..... 15 567 85
Hepatitis, infectious including
serum hepatitis ................ 565 607 607 22,549 24,792 24,794
Measles ........................... 4,047 4,886 4,886 422,517 344,726 370,898
Meningococcal infections .......... 38 37 39 1,611 1,513 1,406
Poliomyelitis, Total .............. 4 11 28 48 114 277
Paralytic ...................... 4 8 18 36 94 190
Nonparalytic ................... 2 --- 9 12 --
Unspecified .................... 1 3 8
Streptococcal Sore Throat and
Scarlet fever .................. 4,263 3,786 --- 259,631 222,069 "
Tetanus ........................... 2 5 --- 130 126
Tularemia ......................... 10 15 --- 164 146 ---
Typhoid fever ..................... 8 26 22 204 218 334
Rabies in Animals ................. 81 70 83 2,556 2,167 2,165

Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: 2 Psittacosis: 18
Botulism: 10 Rabies in Man:
Leptospirosis: 21 Smallpox:
Malaria: Ind-1, Kans-1, Ark-l, Calif-1 48 Typhus-
Plague: Murine: Fla-1 13
SRky Mt. Spotted: Md-2, Va-2, WVa-1 73


Prepared by the


For release July 17, 1964


____


, i. a


I







Morbidily and Mortality Weekly Report


TICK-BORNE TYPHUS OF THE EASTERN HEMISPHERE KENYAA TICK TYPHUS) Maryland


Maryland reported a case of tick-borne typhus of the
Easterm HIlmisphert (Ken.a tick trphus-fievre bouton-
nt'uc-. diagnosed clinically in BaHlimore in a 55-vear-old
white American male who had returned from extended
residence in Ktn.a.
The patient, a State Deparrmenr Official, hunted in
Kerna on several occasions during the prior 18 months.
On his last two safaris, March 2' to 29 and April 3 and 4,
he skinned the animals shot. He frequently removed ricks
from the hunting dog as well as those ticks attached to
his skin.
On the da\ he left Kenya, April 8, the patient noted,
but disr-ygardtd, a non-render lesion in the right axilla.
Shilt enroute to Greece the following day,he experienced
insomnia, a symptom attributed to the stress of travel. On
the da, after arrival in the United States (April 10), he
felt chilly and noted fever of 101.s F. On April 13, his
temperature was 102.40 F. Because of mild headache,
nausea, malaise, fever and the persistence of the lesion
on his axilla, he entered the U.S. Public Health Service
Hospital in Baltimore for a medical check-up. On physical
examination, his conjunctivae were noted to be infected
bilaterally. The axillary lesion, non-tender, was described
as induratedd like a button" with a black center, 1 cm. in
diameter with surrounding erythema (tache noire) and with
three or four satellite lymph nodes. There was no gener-
alized Ilmphadenoparhy. Lungs were clear. Numerous
insect bites were rooted on both legs. His white blood
count was 4,'00 (2" neutrophils, 33 bands, 29 lympho-
cyres, and 11 monocytes).
On the following day, the fourth day of his illness,
the patient demonstrated a maculopapular rash over his
abdomen and buttocks for the first time. The rash became
more pronounced 24 hours later, extending to the soles.
No rash was present on his hands. His temperature rose
to a high of 1030 F. The blood leukocyte count was
11.000.
The diagnosis of a rickettsial disease, tick-borne
typhus of the Eastern Hemisphere (Kenya tick typhus)was
considered as the most likely diagnosis. The patient was
treated with chloramphenicol. Within 24 hours his temper-
ature dropped to 1000 F. and within 48 hours his rash
disappeared. The antibiotic was stopped after 5 days of
therapy, within the 48 hours thereafter, his temperature
rose to 103.80 F., his symptoms of malaise, headache,
and backache, and the conjunciival injection returned.
Antibiotic therapy; was reinstituted and his symptoms
disappeared. The antibiotic was stopped at discharge
April 28. The patient was asymptomatic when examined
for follow-up evaluation on Ma\ 25.
The patient's serum showed a rise in agglutinins to
Proreus OX-2, but not to OX-19:


OX-2

April 15 Neg.
April 20 1:320


OX-19
1:40


Further laboratory studies, including complement
fixation tests are being performed. Attempts to isolate
rickettsiae from the patient's blood were negative.
Specimens of the eschar and skin lesion obtained by
biopsy showed a vascular reaction considered typical of
a rickettsial infection. Ticks obtained from the dog with
which the patient had contact are under evaluation for
the presence of rickettsiae.
(Reported by George F. Ellinger. M.D.. Chier o/ Medicine,
U SPII Hospital, Baltimore, Md.. T. E. Vooduard, M.D..
Pru/essor of Medicine and Head. Department of Medicine,
L nitersil) of Maryland School o/ medicinee. and John H.
Janney, M.D.. M.P.H., Acting Chief. Burea, of Pretentive
Medicine, Division of Epidemiology, Mar)land State
Department of Health..i

editor'ss Note: Kenya Tick Fever is caused by Rickettsia
conorii. The disease is widely distributed geographically,
occurring throughout the African continent, the Mediter-
ranean, Black and Caspian Sea areas, and in India. It is
transmitted by the bite of the brown dog tick and other
ixodid ticks from dog and wild rodent hosts. This case is
an excellent example of the lack of geographical bounda-
ries in the occurrence of exotic diseases in this era of
jet air travel.


ENCEPHALITIS IN HORSES Florida

A total of 51 cases of encephalitis-like illness in
horses has been observed in Florida to date in 1964. Cases
were first reported in March but most occurred in May and
June; there is evidence of continuing infection among
horses.The cases for the most parr concentrated in counties
of the central and north central part of the State. No known
human cases have occurred to date, although one suspect
human case is being investigated at present.
Virologic study of brain specimens from 12 of the
horse cases submitted to 3 State laboratories has resulted
in isolation of Western Equine Encephalitis virus from the
brain of one horse and Eastern Equine Encephalitis virus
from the brains of 3 other horses. Viral agents have been
recovered from brain tissue of 4 others, but as yet these
remain to be identified.
Group A arboviruses have also been recovered from
pools of mosquitoes collected in areas where horse cases
have occurred. Both Western Equine Encephalitis virus
and Eastern Equine Encephalitis virus have been identified
in pools of ruliseta melanura.
Serologic evidence of previous infection with Group A
arboviruses have been detected in a few wild birds and
mammals and in sentinel chickens in the areas of horse
cases. In the ri-county Tampa Bay area, 150 humans with
suspected central nervous system disorders during 1964


(Please turn to page 8)


212








Morbidity and Mortality Weekly Report


TRICHINOSIS OUTBREAK NEW BRIGHTON VILLAGE, MINNESOTA, 1964


Cases
4

3

2



0o


Day of Ingestion





2 2


22 24 26 28
May


Clinical Case


Finh


a I I I


30 I 3 5 7 9 II 13 15 17 19 21 23
June


SSuspect



TRICHINOSIS Minnesota


From 20 to 27 days after a private outdoor barbecue in
New Brighton Village, Minnesota, May 23, 6 of 8 indivi-
duals who ate rare hamburger developed clinical or suspect
cases of trichinosis. (See graph above).
The symptoms varied with each individual and in-
cluded fever, malaise, periorbital edema, muscle pains,
headache, and abdominal discomfort. All but Case 6 had
periorbital edema. Only Case 4 experienced diarrhea. A
line listing appears below.
Two patients required hospitalization; electrocardio-
grams of both patients were interpreted as normal. Acute
sera were submitted to CDC; Bentonire-flocculation tests
for trichinosis were negative. Convalescent samples will
be studied. Muscle biopsies were not performed.
Two packages of hamburger, purchased from different
supermarkets, were used. One was purchased the day of
consumption as "ground round," the other had been pur-
chased earlier and stored in the freezer of the home refrig-
erator until the day of the barbecue. Four patties were
made from the frozen meat, the remainder from the fresh
meat; they were not mixed. There was no known con-


sumption of sausage, ham or pork by the patients. No
hamburger remained for analysis.
The namburger was traced to 2 supermarkets, but no
evidence of substituted or infected meat was found. No
meat grinder, common to both pork and beef was used in
either supermarket.
No other cases have been reported.

(Reported by D. S. Fleming, V.D.. V.P.H.. Director, Divi-
sion of Disease Prevention and Control. Minnesota Depart-
ment of Health)

Editor's Vole: It is not known which batch of hamburger
the ill patients ate. The fact that illness developed in at
least 5 individuals, and that only 4 patties were made
from frozen meat (from which the chance of infection would
be less), would make the fresh meat more suspect. Were
this the case, (hen the consumption of the 4 frozen patties
could be accounted for by the 2 guests who remained well
and by Cases 3 and 4, who each ate an additional ham-
burger.


Individuals Amount Hamburger Incubation
Attending Party Age Sex 1 Patties Consumed Period Eosinophilia Severity
III
1 41 F <1 20 days 29-50% Hospitalized
2 35 F 1 20 days 25-39% Hospitalized
3 33 F 2 24 days N. R. In and out of bed
4 39 M 2 24 days N. R. Out of work 1 week
5 37 M 1 25 days N. R. Out of work 4 days
6* 28 F <1 27 days N. R. No orbital edema; leg muscle pain
Not III
7** Unknown M 1 -
8** Unknown F 1 -

*Suspect; **Asymptomatic; N.R. Not Reported.


...-...~.


243


0-










241 Mlorbidilt and lMortality eeklh Report


Tablc 4 ( ASES OF SPECIFIED NOTIFIABLE DISEASES. UNITED STATES

FOR WEEKS ENDED

JULY 11. 1964 AND JULY 13, 1963 (28TH WEEK)


Encephali ic
Aseptic
Meningitis Primary Post-Inf. Poliomyelitis, Total Cases Poliomyelitis, Paralytic
Ar ea
Cumulative Cumulative
16'. 1963 196. 1964 1964 1963 19641 1963 196. 1963 1964 1963
UNITED STATES... 34 49 32 15 4 11 48 114 4 8 36 94

NEW ENGLAND.......... I I I I I I
Haine .............. 1 I
New Hamp hir ...... -
Verm.nt ......... .... -
Hascachuse' t ...... -
Rhode Island ....... -
Connecticut........ I I 1 -

MIDDLE ATLANTIC...... I 6 2 2 7 31 2 1 7 23
New Yrk City...... 1 2 I 1
Neu York, p-State. 1 2 4 5 2 4 5
New Jersey......... 2 2 2 -
Pennsylvania ....... 2 26 1 18

EAST NORTH CENTRAL... 6 10 8 1 1 6 19 5 14
Ohio............... 2 2 5 2 5 2 3
Indiana ........... 1 1 2 1
Illinois........... 3 1 1- 3 7 3 6
Michigan........... 3 4 1 3 3
Wisconsin.......... I -I 2 -

WEST NORTH CENTRAL... 4 5 7 2 1 2
Minnesota .......... 3 5 I 2 2
Iowa.... ............ I -
Missouri ........... 2 1 -
North Dakota ....... -
South Dakota ....... .
Nebraska............ -
Kansas.............. .- 2 .

SOTTH ATLANTIC....... 1 1 1 19 13 1 1 14 10
Delaware............ -
Maryland........... I 1 1 -
Dist. of Columbia.. -
Virginia............ 2 1
West Virginia ...... 1 1 1
North Carolina.... 8 3 4 3
South Carolina..... 1 2 3 1 2 2
Georgia............ -1 1 -- 1 -
Florida............... i 6 3 1 5 3

EAST SOUTH CENTRAL... 3 10 2 6 4 17 6 2 15
Kentucky........... 3 2 -
Tennessee .......... 1 2 2 4 2 1 4
Alabama............ 1 3 2 II 3 1 9
Mississippi ........ 8 2 1 2

WEST SOUTH CENTRAL... 1 6 2 2 15 2 15
Arkansas............ 1 1
Louisiana .......... 1 I 1 12 12
Oklahoma ........... .- I 1 1
Texas ..............** 5 2 1 2 1 2

MOUNTAIN............. 1 1 3 6 1 3 1
Montana ............
Idaho............... 1 -
Wyoming............ -2 2 -
Colorado........... 3 I 1 -
New Mexico......... 3
Arizona.............
Utah.................
Nevada.............

PACIFIC.............. 17 16 4 14 1 1 15 1 13
Washington.......... I 1 -
Oregon............. 2 1 1 2 1
California........ 16 16 4 12 12 11
Alaska.............
Hawaii ............

Puerto Rico 4 -









Morbidity and Mortality Weekly Report 215


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JULY 11, 1964 AND JULY 13, 1963 (28TH WEEK) CONTINUED


Infectious Hepatitis
Brucellosis Diphtheria including Serum Hepatitis Typhoid Fever
Area Under 20 years Age
Cum. Cum. Total 20 years and over Unknown Cumulative Cum.
1964 1964 1964 1964 1964 1964 1964 1964 1964 1963 1964 1964

UNTTED STATE<... 12 212 6 144 565 237 298 30 22,549 24,792 8 204

NEW ENGLAND .......... 2 42 58 23 34 1 2,257 2,690 1 12
Maine.............. 39 19 8 11 744 1,255 -
New Hampshire....... -- 5 2 3 164 203 -
Vermont............ 9 6 3 283 35 -
Massachusetts ...... 2 3 6 1 4 1 465 780 5
Rhode Island....... 120 62 1 6
Connecticut........ 19 6 13 481 355 1

MIDDLE ATLANTIC ...... 3 5 108 40 68 5,089 4,730 2 32
New York City...... 1 27 8 19 752 675 1 13
New York, Up-State. 1 41 20 21 2,289 2,105 7
New Jersey......... 2 17 2 15 912 720 1
Pennsylvania....... 2 2 23 10 13 1,136 1,230 1 11

EAST NORTH CENTRAL... 25 6 87 32 47 8 3,414 4,033 2 50
Ohio............... 1 18 3 12 3 906 1,117 23
Indiana............. 1 8 3 3 2 307 377 1 10
Illinois........... 15 6 18 7 9 2 579 863 7
Michigan........... 4 38 15 23 1,379 1,495 7
Wisconsin.......... 4 5 4 1 243 181 1 3

WEST NORTH CENTRAL... 5 99 21 18 11 7 1,237 1,147 16
Minnesota.......... 5 11 6 4 2 117 182 1
Iowa............... 3 58 2 2 177 212 3
Missouri........... 1 8 2 1 1 316 437 6
North Dakota ....... 2 2 2 2 47 29 2
South Dakota....... 1 13 1 1 1 106 63 1
Nebraska........... 11 3 1 2 32 84 -
Kansas.............. 2 7 2 1 1 442 140 3

SOUTH ATLANTIC ...... 19 1 29 48 23 22 3 2,130 2,573 2 44
Delaware............ 41 35 -
Maryland........... 6 5 1 413 312 2
Dist. of Columbia.. 33 71 -
Virginia........... 8 16 5 8 3 328 552 1 10
West Virginia...... 3 3 339 405 -
North Carolina..... 2 3 1 2 382 641 12
South Carolina..... 1 5 71 103 1 5
Georgia............ 6 20 3 3 51 111 1
Florida............ 3 4 17 9 8 472 343 14

EAST SOUTH CENTRAL... 1 11 1 6 42 20 20 2 1,557 2,497 21
Kentucky........... 3 11 2 7 2 633 719 6
Tennessee.......... 1 4 1 10 7 3 531 985 8
Alabama............. 3 1 3 9 3 6 255 381 5
Mississippi........ 1 2 12 8 4 138 412 2

WEST SOUTH CENTRAL... 3 21 1 19 53 31 20 2 1,679 1,690 11
Arkansas........... 4 1 1 174 184 4
Louisiana.......... I 5 10 8 2 382 325 3
Oklahoma........... 1 3 3 3 90 83 3
Texas.............. 2 13 1 14 39 19 18 2 1,033 1,098 1

MOUNTAIN ............. 2 18 1 2 23 6 4 13 1,398 1,651 1 5
Montana ............ .- 2 1 1 126 224 -
Idaho.............. 6 6 152 259 -
Wyoming........... 45 23 1 1
Colorado............ 2 1 1 395 348 -
New Mexico........ 1 1 4 3 1 197 199 -
Arizona............. 1 2 1 1 5 5 317 393 4
Utah............... 1 14 3 1 2 124 192 -
Nevada............. 1 1 1 42 13 -

PACIFIC.............. 1 14 2 14 128 51 76 1 3,788 3,781 13
Washington ......... 2 13 13 6 7 436 653 1
Oregon.............. 1 2 6 2 3 1 410 494 -
California......... 12 1 99 36 63 2,744 2,541 12
Alaska............ 7 7 122 68
Hawaii............. 3 3 76 25 -

Puerto Rico 7 12 12 440 423 9









21 Morbidilt and Morlalit W'eekl Reporl


Tabic I CASES OF SPECIFIED NOTIFIABLE DISEASES. UNITED STATES

FOR WEEKS ENDED

JULY II. 1964 AND J'LY Ii. 1963 (28TH WEEK) CONTINUED


Etreptococcal
Meningocoiccal Sore Thr.'al and Rabies in
Measles Meningitis Scarlet Fever Tetanus Tularemia Animals
Are i
Cumulative Cum. Cum. Cum.
196. 196- 1964 1963 1964 1963 1964 1964 196. 1964 1964 1964

UNITED 'TATEI... .,047 38 1,611 1,513 4.263 3,786 2 130 10 164 81 2,556

NEW En.LAND.. ....... 353 1 47 93 530 304 5 1 17
Ma ne .............. 93 5 16 93 34 1 15
New HAmpsh re ...... I I 19 46 1
Vermnt ............ 67 I 3 2 I
.lassachusetts...... 98 19 42 26 50 5 -
Rhode Island....... 19 7 9 5 -
Cnnecticut... ..... 75 1 14 19 345 167 -

MIDDLE ATLANTIC...... 549 4 200 206 232 132 9 7 74
New v 'rk City...... 128 1 28 30 7 6 -
New York, Up-State. 255 I 55 65 194 74 2 6 70
New Jersey ......... 131 69 29 8 34 5 -
Pennsylvania ...... 35 2 48 82 23 18 2 1 &

EAST NORTH CENTRAL... 861 6 229 241 409 349 I 21 1 14 8 346
Ohio............... 63 I 62 69 14 13 1 4 1 179
Indiana............ 171 1 35 30 148 59 3 1 2 19
Illinos ........... 46 54 44 70 62 7 1 9 75
Michigan........... 4 l 3 52 711 141 140 6 1 3 32
Wisconsin.......... 170 I 26 27 36 75 I 2 3 41

WEST NORTH CENTRAL... 172 6 103 89 174 110 7 3 35 29 830
Minnesota .......... 20 22 18 6 4 1 1 8 249
lowa............... 86 6 5 34 23 2 1 10 297
KMssourt........... 4 4 52 30 60 2 2 21 3 129
North Dakota....... 62 1 11 4 40 *0 -1 45
South Dakota...... 5 2 5 1 1 4 2 68
Nebraska............ 6 19 23
Kansas............... NN 6 8 32 38 1 8 5 19

SOUTH ATLANTIC....... 348 8 35'. 286 551 243 42 1 19 7 339
Delaware............ 3 6 2 I -
Maryland........... 10 1 2? 44 20 37 3 -
Dist. of Columbia.. 12 4 -
Virginia........... 59 39 69 101 41 5 4 1 192
West Virainia...... 100 2 26 15 104 72 1 23
North Carolina..... 39 59 51 8 9 12 4 4
South Carolina..... 26 .8 13 38 21 3 1
Georgia............. 2 46 22 10 1 1 11 3 69
Florida............ 109 3 94 66 270 62 17 3 50

EAST SOUTH CENTRAL... 315 .. 145 117 632 774 15 19 5 323
Kentucky........... 35 1 47 25 50 65 2 1 44
Tennessee.......... 252 2 49 51 512 651 8 12 5 265
Alabama............. 18 I 31 21 53 14 4 3 14
Mississippi........ 10 18 20 17 44 1 3 --

WEST SOUTH CENTRAL... 461 6 150 150 654 596 1 14 3 51 10 370
Arkansas ........... 1 2 19 10 3 1 5 2 30 4 93
Louisiana......... 2 2 102 62 3 1 3 1 31
Oklahoma ........... 1 1 7 29 8 42 16 3 63
Texas.............. 457 1 22 49 640 553 6 1 4 3 183

MOUNTAIN............. 271 59 52 478 769 4 2 26 7 93
Montana............... 62 3 11 30 2 16 -
Idaho............... 50 3 4 81 60 -
Wyoming............. 6 3 4 6 4 I --
Colorado........... 52 11 12 40 244 1 6
New Mexico ........ 3 1 23 4 160 219 1 5 64
Arizona............ 45 1 5 8 71 96 1 1 42
Utah............... 40 6 14 109 101 1 6 -
Nevada............ 13 8 3 15 1

PACIFIC.............. 717 I 324 279 603 509 13 7 164
Washington......... 31 25 21 71 63 1 -- -
Oregon.............. 215 118 8 8 7 1 4
California......... 453 1 265 225 506 410 11 6 160
Alaska.............. 6 8 3 -
Hawaii ............. 14 10 7 15 21 1 -

Puerto Rico 162 26 5 7 6 43 14








Morbidity and Mortalily Weekly Report





TA.hl ()) TOTAL DEATHS AIMON(, PERSONS (65 'FARS AND O(VIR IN RIPORTIN( ( IltS



(Tables 4(A), *(B), i(C), and 4(D) will be published in sequence covering a four-week period.)0


247


Arta For weeks ending ea For weeks ending
Arra20 6/27 Area7/11 1620 627 171 7/11

6/20 6/27 7/4 7/11 6/20 6/27 7,: 7/11


NEW ENGLAND:
Boston, lass..............
Bridgeport, Conn..........
Cambridge, Mass...........
Fall River, Mass..........
Hartford, Conn............
Lowell, Mass .............
Lynn, Mass.................
New Bedford, Mass.........
New Haven, Conn...........
Providence, R.1...........
Somerville, Mass..........
Springfield, Mass.........
Waterbury, Conn...........
Worcester, Mass...........

MIDDLE ATLANTIC:
Albany, N.Y...............
Allentown, Pa..............
Buffalo, N.Y ..............
Camden, N.J...............
Elizabeth, N.J............
Erie, Pa..................
Jersey City, N.J..........
Newark, N.J ...............
New York City, N.Y........
Paterson, N.J.............
Philadelphia, Pa..........
Pittsburgh, Pa............
Reading, Pa ...............
Rochester, N.Y.............
Schenectady, N.Y...........
Scranton, Pa..............
Syracuse, N.Y.............
Trenton, N.J...............
Utica, N.Y................
Yonkers, N.Y..............

EAST NORTH CENTRAL:
Akron, Ohio...............
Canton, Ohio ...........
Chicago, Ill..............
Cincinnati, Ohio...........
Cleveland, Ohio...........
Columbus, Ohio............
Dayton, Ohio...............
Detroit, Mich.............
Evansville, Ind...........
Flint, Mich ...............
Fort Wayne, Ind..........
Cary, Ind.................
Grand Rapids, Mich........
Indianapolis, Ind.........
Madison, Wis..............
Milwaukee, Wis............
Peoria, ll ...............
Rockford, III.............
South Bend, Ind...........
Toledo, Ohio..............
Youngstown, Ohio..........

WEST NORTH CENTRAL:
Des Moines, Iowa.........
Duluth, Minn.............
Kansas City, Kanra........
Kansas City, Mo...........
Lincoln, Nebr...........
Minneapolis, Minn........
Omaha, Nebr..............
St. Louis, Mo.............
St. Paul, Minn...........
Wichita, Kans............


132
33
23
15
23
13
18
18
32
45
5
32
22
43


36
22
80
18
21
24
30
58
990
24
271
137
33
67
16
20
36
36
16
28


45
21
436
84
140
48
39
197
22
30
18
26
20
82
16
66
16
15
24
57
45


36
14
23
87
12
67
37
154
39
34


126
42
13
21
22
17
19
12
30
35
8
38
18
32


40
14
87
30
19
24
49
53
1,036
24
305
11l
31
61
13
34
39
17
29
22


44
22
525
92
123
73
59
206
21
20
20
18
34
106
24
98
10
23
22
57
35


39
15
27
102
31
101
61
126
51
33


NOTF: q1l death by place ol occurrence.


SOUTH ATLANTIC:
Atlanta, Ga ......... .... 43 62 51 62
Baltimore, Md........... 104 124 116 116
Charlotte, TI.C ........... 28 13 7 20
Jacksonville, Fla........ 29 32 23 36
Miami, Fla............... uu 42 38 41
Norfolk, Va.............. 26 35 22 19
Richmond, Va............. 36 51 26 45
Savannah, Ca.............. 7 17 18 22
St. Petersburg, Fla...... 65 66 64 47
Tampa, Fla........... ... 43 49 32 39
Washington, D.C.......... 99 70 88 94
Wilmington, Del.......... 24 21 10 28

EAST SOUTH CEINTAL:
Birmingham, Ala.......... 42 45 47 31
Chattanooga, Tenn........ 23 23 46 32
KnoCville, Tenn.......... 24 24 19 27
Louisville, Ky........... 83 u8 83 70
Memphis, Tenn............. 60 73 5 78
Mobile, Ala.............. 14 26 13 27
Montgomery, Ala.......... 21 21 33 16
Nashville, Tenn.......... 53 50 36 59

WEST SOUTH CENTRAL:
Austin, Tex.............. 22 13 20 16
Baton Rouge, La.......... 12 15 12 17
Corpus Christi, Tex...... 12 20 1 14
Dallas, Tex............... 67 68 77 58
El Paso, Tex .. ......... 12 21 12 32
Fort Worth, Tex.......... .4 32 23 44
Houston, Tex.............. 87 101 73 71
Little Rock, Ark......... 31 33 13 35
New Orleans, La.......... 90 91 56 85
Oklahoma City, Okla...... 37 30 40 54
San Antonio, Tex.......... 58 53 51 69
Shreveport, La........... 38 31 25 22
Tulsa, Okla............... 29 27 18 45

MOUNTAIN:
Albuquerque, 11. Mex...... 13 11 10 23
Colorado Springs, Cole... 11 10 13 15
Denver, Colo............. 56 59 77 58
Ogden, Utah.............. 8 6 6 12
Phoenix, Ariz............ 29 47 49 71
Pueblo, Cole............. 9 7 11 9
Salt Lake City, Utah..... 33 29 28 28
Tucson, Ari ............. 27 24 20 22

PACIFIC:
Berkeley, Calif.......... 11 5 11 10
Fresno, Calif............ 21 25 29 33
Glendale, Calif.......... 18 27 32 23*
Honolulu, Hawaii......... 15 28 18 21
Long Beach, Calif........ 33 38 34 -0
Los Angeles, Calif....... 284 275 231 2-2
Oakland, Calif............ u7 57 79 53
Pasadena, Calif.......... 20 30 22 23
Portland, Oreg............ 70 88 51 56
Sacramenct Calif........ 40 29 32 28
San Diego, Calif......... 40 52 57 42
San Francisco, Calif..... 106 102 109 94
San Jose, Calif.......... 15 13 20 9
Seattle, Wash............ 81 96 70 77
Spokane, Wash............. 32 40 27 28
Tacoma, Wash............. 28 23 31 28

San Juan, P.R............... (---) ---) (---) (---)


0Current Week Mortality for 108 Selected Cities

4(A) Total Mortality, all ages................... 12,213
4(B) Pneumonia-Influenza Deaths, all ages........ 424
4(C) Total Deaths under 1 Year of Age............. 785
4(D) Total Deaths, Persons 65 years and over..... 6,839


*Estimate based on average percent of divisional cotal.
Totals for previous weeks include reported corrections.





IIInIIIIi IIII2II 4 l
3 1262 08864 2946


Morbidity and Mortality Weekly Report


248


SUMMARY OF DEATHS AMONG PERSONS 65 YEARS
AND OVER IN 108 U.S. CITIES

The weekly average number of deaths among persons
65 years and over in 108 cities for the four-week period
ending July 11 was 6,365 as compared with an expected
weekly average of 6,237.


Week Ending 4 Week Weekly

6-20 6/27 7/4 7/11 Total Average

Observed 6,082 6,563 5,975 6,839 25,459 6,365
Expected 6,302 6,256 6,214 6,176 24,948 6,237

Excess 220 307 -239 663 511 128


were investigated serologically
of recent arbovirus infection.


and none showed evidence


(Reported by C.M. Sharp, M.D., Acting Director, Bureau of
Preventable Diseases, Florida State Board of Health, and
James O. Bond, M.D., Director, Encephalitis Research
Center, Florida State Board of Health, Tampa, Florida.)

Editor's Note: The recovery of Western Equine Encephalitis
from horses is unusual in the eastern third of the U.S.A.,
although it is occasionally isolated in this area from
mosquitoes. The isolation of the agent from a horse in
Florida appears to be the first such isolation in that
State.


2oDr--- -
NUMBER
OF O.--.

I.--


DEATHS at AGE65 and OVER tn 108 US. CITES
,twae MilmtM p Wpa, by tlwr-Weett ArIa



r-
--I


*96 .9295 I


*w .AC o oSon


LINIV OF FL LIB


UNIV OF FL LIB
QOC JMENTS DEPT






US 'DEPOSITORY


C**M-cunpoE WO 01-E m.- M


(See Table, page 67)


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THE MORBIDITY AND MORTALITY WEEKLY REPORT, WITH A CIRCULA-
TION OF 11,000 IS PUBLISHED BY THE COMMUNICABLE DISEASE
CENTER, ATLANTA, GEORGIA.
CHIEF. COMMUNICABLE DISEASE CENTER JAMES L.GODDARD, M.D.
CHIEF, EPIDEMIOLOGY BRANCH A. D. LANGMUIR. M.D.
CHIEF. STATISTICS SECTION R. E. SERFLING, PH.D.
ASST. CHIEF, STATISTICS SECTION 1. L. SHERMAN. M.S.
CHIEF. SURVEILLANCE SECTION 0. A. HENDERSON, M.D.
EDITOR. MMWR L. K. ALTMAN, M.D.
IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDITY AND MORTALITY, THE COMMUNICABLE DISEASE CENTER
WELCOMES ACCOUNTS OF INTERESTING OUTBREAKS OR CASES, SUCH
ACCOUNTS SHOULD BE ADDRESSED TOI
LAWRENCE K. ALTMAN, M.D., EDITOR
MORBIDITY AND MORTALITY WEEKLY REPORT
COMMUNICABLE DISEASE CENTER
ATLANTA, GEORGIA 30833
NOTES: THESE PROVISIONAL DATA ARE BASED ON WEEKLY TELE*
GRAMS TO THE COMMUNICABLE DISEASE CENTER BY THE INDIVIDUAL
STATE HEALTH DEPARTMENTS.
SYMBOLS DATA NOT AVAILABLE
QUANTITY ZERO
PROCEDURES FOR CONSTRUCTION OF VARIOUS MORTALITY CURVES
MAY BE OBTAINED FROM STATISTICS SECTION. COMMUNICABLE
DISEASE CENTER, PUBLIC HEALTH SERVICE, U.S. DEPARTMENT OF
HEALTH, EDUCATION, AND WELFARE, ATLANTA, GEORGIA 30313.


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